PROFESSIONAL PRACTICE IN

PHYSICAL THERAPY
Dr Sharjeel Tasneem
 THE PHYSICAL THERAPIST AS
PROFESSIONAL
• What does professional mean?
A profession is an occupation that is viewed by society as a profession on
the basis of its characteristics, development, or power.
Professionalism is the internalized conceptualization of expected
professional obligations, attributes, interactions, attitudes,
values, and role behaviors in relation to individual patients and clients
and society as a whole. Professionalism may be collective (practiced by
the profession as a whole) or individual.
Individual professionalism refers to the internalized beliefs
of an individual member of a profession regarding professional
obligations, attributes, interactions, attitudes, values, and role behaviors.
might also be called “professional role concept.”
 Sociological Perspective

According to Ritzer, sociological literature about the professions takes

three approaches:
• Structural processual (or process), and power.
The structural approach focuses on the static characteristics that an
occupation must possess to be considered a profession.
The process approach focuses on either the stages and developmental
periods that an occupation must pass through or activities that its
members must perform to achieve recognition as a profession.
Those advocating the power approach believe that a profession’s
ability to obtain the political and social power to define its work is its
most important characteristic. These three approaches are not
mutually exclusive.
Indeed, when defining the term profession, most people blend these
approaches.
Structural Approach
The classic definition of a
profession includes at least four:
• a body of theoretical knowledge,
• some degree of professional autonomy,
• an ethic that the members enforce,
• and accountability to society.
CHARACTERISTICS OF PROFESSIONS CITED IN THE LITERATURE
Knowledge
● Broad, theoretical, generalized, systematic knowledge
● Unique body of knowledge
● “Formal” knowledge—knowledge that is “embodied and applied in and
through the professional
Autonomy in professional decisions
● Autonomy from client
● Autonomy from organizations or external parties
● Autonomy in selecting colleagues
Authority
● Based on internal knowledge
● Granted by society
● Demonstrated by power and status in society
● Demonstrated by monetary and symbolic awards
Education
● Extensive*
● Skilled, technical,
● High standards for admission
Responsibility, Accountability, and Ethics
● Service orientation
● Accountability and responsibility to society
● Formal code of ethics that members enforce
● Self-control of behavior through internalized
professional ethic
● Belief in self-regulation
● Community interest more important than self-interest
● Fiduciary* relationship and trustworthiness central
Nature of work and decisions
● Important or essential to clients
● not Complex
● Not routine
● Not programmed
Role and Identity
● Internally based on a sense of calling
● Formed and driven by the professional group
● Extending beyond the specific work situation
Processual Approach
The social processes or developmental stages through which
occupations move to attain the power and status that
professions have traditionally held in society
Moore and Pavalko built on the idea of autonomy as the
defining attribute of professions in developing a continuum or
hierarchy of professionalism.
A hierarchical continuum of characteristics combines
the structural and processual approaches to defining a
profession.
Pavalko’s continuum allows assessment of an occupation’s level
or stage of professionalization .
• Power Approach
The academic shift toward analysis of the use and abuse of
power by the professions was accompanied by changes in
public opinion regarding the professions. Scholars and
members of the public criticized the professions for setting
up economic monopolies, using political power for self
interest, and focusing on professional autonomy and self-
governance without consideration of the public welfare.
The requirement for licensure is one strategy for using
political power to create an economic monopoly and
decrease competition for members of a particular
profession.
 AUTONOMY, SELF-REGULATION OF ETHICAL STANDARDS, AND
ACCOUNTABILITY
Autonomy can be defined as the “extent to which [a profession]
or an individual feels freedom and independence in his/her role.
This includes freedom from clients (those outside the profession)
and the organization that employs the professional.
 Privileges of Autonomous Practice in 2020

Each of these elements includes two overarching

concepts: recognition of and respect for physical
therapists as the practitioners of choice, and recognition
of and respect for the education, experience, and
expertise of physical therapists in their professional scope
of practice.
1. Direct and unrestricted access: The physical therapist
has the professional capability and ability to provide to
all individuals the physical therapy services they
choose without legal, regulatory, or payer restrictions.
3. Professional ability to refer to other professionals:
The physical therapist has the professional capability
and ability to refer to other professionals for identified
patient/client needs beyond the score of physical
therapist practice.
4. Professional ability to refer for diagnostic tests: The
physical therapist has the professional capability and
ability to refer for diagnostic tests that would clarify
the patient/client situation and enhance the provision
of physical therapy services.
• Self-Regulation of Ethical Standards
A second important characteristic of professionals is ethical
conduct and self regulation.
This includes the possession of a code of ethics and mechanisms
that ensure members abide by the code’s principles.
The American Physiotherapy Association, adopted its first code
of ethics .
The first code identified four major ethics violations:
making a diagnosis, offering a prognosis, advertising for
patients, and criticizing the doctor or other co-workers.
• Accountability of Professionals
The third important attribute of professionals is
responsibility and accountability.
Taken together, these terms mean that professionals
have obligations and must “account” to the public for
the discharge of these duties.
Emanuel and Emanuel define accountability as “the
process by which a party justifies its actions and
policies”
According to APTA (2003) the professionalism in
physical therapy is
The seven core values of professionalism are
defined as
accountability, altruism*, compassion/caring,
excellence, integrity, professional duty, and
social responsibility.
 History Of Profession
The first decades of the twentieth century were
exciting times in the development of physical
therapy, with many firsts occurring:
Pennsylvania became the first state to license
PTs; the first physical therapy textbook and the
first journal devoted to physical therapy were
published.
• The creation of the American Women’s Physical
Therapeutic Association (AWPTA) coincided with
passage of the Nineteenth Amendment, which gave
women the right to vote. The political action may have
encouraged the small group of “reconstruction aides”
to create this new profession for women in the
aftermath of World War I, as the United States
developed programs to provide care for injured
soldiers, workers, and the children devastated by the
effects of infantile paralysis, or poliomyelitis (known
simply as polio).
The years 1940 to 1969 were marked by the
passage of legislation supporting the training of
allied health personnel, the building of hospitals,
and the creation of Medicare and Medicaid
Soldiers injured in World War II and in Korea and
Vietnam required the attention of PTs in the
military and in Veterans
Administration hospitals.
In 1956 the American Physiotherapy Association
(formerly the AWPTA) changed its name to the
American Physical Therapy Association and became
more structurally complex through the creation of
special interest groups and sections.
During this time the APTA became solely responsible
for the accreditation of PT educational programs,
developed specialty sections and specialty
certification, and defined itself through the Guide to
Physical Therapist Practice.
 Priority Goals of the American Physical
Therapy Association (APTA) (2004)
Goal I: PTs are universally recognized and
promoted as the practitioners of choice for
persons with conditions that affect movement,
function, health, and wellness.
Goal II: Academic and clinical education
prepares doctors of physical therapy who are
autonomous practitioners.
Goal III: PTs are autonomous practitioners to whom
patients/clients have unrestricted direct access as an entry
point into the health care delivery system and who are
paid for all elements of patient/client management in all
practice environments.
Goal IV: Research advances the science of physical therapy
and furthers the evidence-based practice of the PT.
Goal V: PTs and PTAs are committed to meeting the health
needs of patients/clients and society through ethical
behavior, continued competence, and advocacy for the
profession.
Goal VI: Communication throughout the Association enhances
participation and responsiveness to members and instills the
value of belonging to the APTA.

Goal VII: APTA standards, policies, positions, guidelines and the

Guide to Physical Therapist Practice, Normative Model of
Physical Therapist Education and Evaluative Criteria, and the
Normative Model of Physical Therapist Assistant Education and
Evaluative Criteria are recognized and used as the foundation for
physical therapist practice, research, and education
environments
THANK YOU